GET IT: The VA Patient Record Flags Manual

VA Flag

VA Flag

While you were out fighting wars for the Flag defending our rights, many of you were unaware VA stood ready to give you a flag of its own – this time to take your rights away.

Yesterday, I came across the most current Patient Record Flags Manual (PRF) used by VA staff to deny veterans their right of access to health care without due process.

After reviewing its pages, the Patient Records Flags Manual should be renamed – something like the “Unconstitutional Veteran Targeting Guide,” since that is what it does in function.

It is used to “warn” VA employees about disgruntled veterans and thought some of you would like to see it. Here is what VA says it does:

Patient Record Flags (PRFs) are used to alert Veterans Health Administration (VHA) medical staff and employees of patients whose behavior and characteristics may pose a threat either to their safety, the safety of other patients, or compromise the delivery of quality health care.

The last part of this explanation is what really concerns me. What does “compromise the delivery of quality health care” mean? That is a very ambiguous definition if I have ever seen one.

Now, last week I wrote about VA Disruptive Behavior Committees. These are the secret bureaucratic committees that decide whether or not to flag veterans without providing due process first. The veteran then has his or her right of access to care restricted without prior notice.

The good news this week is that I found their manual last night. This is important for two reasons. First, you can now read up on how VA employees flag you. Second, and even better, you get to know what the keywords are when you request your file under the Privacy Act. Since VA is required by law to provide you with a copy of any records they have about you, knowing the terms is a good start.

If you skip to page 27, the PDF explains what an authorized user must include when assigning a flag to a veteran:

Patient Record Flags (PRF) are advisories that authorized users place on a patient’s chart to improve employee safety and the efficient delivery of health care. Each advisory or flag includes a narrative that describes the reason for the flag and may include some suggested actions for users to take when they encounter the patient. Other information displayed to the user includes the Flag Type, Flag Category, Assignment Status, Initial Assignment Date, Approved by, Next Review Date, Owner Site, and Originating Site. When assigning a flag, authorized users must write a progress note that clinically justifies each flag assignment action.

That is the information and record you want to get. If there is an error, you may be able to remove the flag. If the problem is defamatory in nature, you may be able to sue the VA for damages.

For me, the next step is to figure out the right fact set to reverse this trend of harming veterans. While I am sure some veterans need some form of a flag, I am also aware of numerous veterans who were unfairly targeted for a variety of unreasonable reasons. I guess they must have interfered with that “quality health care.” [sic]

This discussion of Patient Record Flags has me fired up because of the clear unconstitutional nature of the program. It reminds me of the old Communist techniques used to keep Soviet citizens in check, since I am aware of more than a few veterans who are flagged merely because of their threat to sue VA.

What do you think the manual should be called and what should we do about it?

Download the PRF Manual here:

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  1. Yes…just got my flag..secret board assigns your flag..a secret panel..with no representation to the veteran..this isStalinist..Communist..and just plain lame..the care is so bogus at VA..I was ..warned..and the employees are..garbage at best..they do the bare minimum to get rid of you..i swore and got..fagged..Lame!!

  2. I have been flagged since 2005, I refused to take any statin drugs and found out all of my tests were normal, I just turned 65 and my new doctors Have advised me to retain a lawyer to go after the VA with, she is going to sue VA for pútting me in a wheelchair for life. Even tho the malpractice is over ten years, it seems like if you didnt know what they were doing makes it ok to sue them, at least in Florida

  3. i’m the poster child for red flagged vets ! i have been flagged for 4 yrs now as a combat vet the red flag was our enemy flag i have been hurt stop calling us names i fought for my country and freedom you are not worth it just do your job

  4. I am so happy to have found this article!!!! I need serious help with a situation regarding this flagging crap and being denied medicine for a service connected disability. I once had a doctor that was tearing my mental health issues who removed diazepam, flagged me and left the VA. Three years later after 8 months of me being back on it for muscle spasms my doctor gets a call from the VA pharmacy stating he can’t provide it and their reasonings. He will no longer provide it due to this defamation of character. Practically ruined our Doctor-patient relationship, no phone call as to why I never received the medicine. That is the worst quality of care I have ever seen.

  5. On January 16th my right arm became infiltrated while being treated in ICU for a pulse of less than 20BPM.
    Shortly after my arm began swelling and several blisters manifested. At first the nurses and attending doctor were forthcoming in what occurred. Then I overheard the doctor telling my family member that the cause of my blisters was not from infiltration but rather the over enthusiastic insertion of my IV by a paniced nurse.
    I knew then the VA was backtracking on their story so I requested copies of my progress notes . After a week of antibiotics and morphine I was sent home with instructions to keep the bandaged changed daily and keep the arm elevated. Living alone I not sure how they expected me to tend to my wound with only one arm.
    I returned to the ER that same night and was because of vomitting bile. I was sent back home.That afternoon I reported to my treatment team and was told to report to the ER.I explained I had just spent the night there and was told there was nothing they could do.
    Long story short the blisters burst and became one large wound which began to fester and smell. The only treatment I ever got was morphine and antibiotics for a week and going back home.
    A home health care nurse was assigned 2 days a week but the expectation was for me to change the bandages daily.
    After being admitted to a civilian hospital the wound was debreeded and the rot and stench dissipated
    The VA if course reuses to pay the bill stating it is not part of my service connection.
    In fact because I loudly demanded the VA treat my arm I was placed on the required Armed escort list even though I threatened no one nor destroyed property I merely loudly begged for help.

  6. the VA is ran by a bunch of greedy little rats that they themselves have never served in the military or have done anything for this but put veterans through a hard time and the most of all things that piss me off is that they get bonuses for keep the numbers low. yesterday in the USA news paper on the front page was a top story the VA admitted again they have be lying about the wait times for veterans. why are these same lairs not in jail. people need to understand sthat this comes from the top the white house and his treasonous traitors ass how he hates the military and not to long ago he took almost three billion dollars away from the VA and gave it to the illegals coming over the borders I get pissed because so many zombies that are brain dead and still thins he is a good President. so many VA hospitals still treats Veterans bad and no one in this administration cares but yet the military guards his fraud ass. Semper Fi

  7. They now flag your records if they feel you are suicidal. Did you know that flag gives out you total social security number? Yup it does and my identity has been stolen. This flag comes up to anyone with access to a VA medical record. This includes clerks. It is unethical to make a veterans medical issue known to non medical staff. I stopped therapy because I did not want people opening my record. I have gone to the director with no help. Couldn’t even get to the privacy officer. Look in You can read your record and it you have been flagged, it is there.

  8. I’ll have to ask about this myself, I have service connection for depression among other things, and the V.A. emergency room in Muskogee turned me away on June 26th while I was asking to see a psychology Dr. no amount of calls to their directors office, nor visits to the office of Senator Inhoffe helped… And the reply back from V.A.’s website was that the V.A. was unaware of any problems. But I had recently requested a change of provider, and that may have caused Dr. Floyd to view me as an unwanted burden rather than a veteran in need of care.

  9. Dennis, I found out you don’t confront the doctor in question every hospital has a Privacy Officer, you need to have them send you a special form and for every inaccurate note you have to fill out one of these forms. They are given so many days to correct it unless they feel it’s important information. At any rate you can only contact a privacy officer and correct your records through that. It’s part of FOICA and HIPPA acts. I’m trying to go over and repair many lies they call ‘misunderstandings” because all Doctors are LLC’s and capable of legally lying to you protected by Government Departments.

    Statute of limitations on medical neglect/malpractice is 2 years. File a form 95 out and send it to Washington and your local regional office. It’s better to have a lawyer take up your case before you fill one out but they still need to deny it before you can persue a civil lawsuit.

    Form 95’s can be found in your patient advocate’s office.

  10. the BBB does not recommend going to the VHA Hospitals.
    I recently had an appointment with a pain clinic.
    They knowingly lied to me about my back healing when they had no MRI’s on that area to gather information from. Then the Dr in Murfeesboro went to get her Head Doctor which I think was just a colleague and he started telling me all the medications I’ve been taking for 5 years were wrong and I shouldn’t be taking them and that I didn’t need a back brace when I had driven an hour and needed to drive an hour back home. I realized they were trying to get me thrown in the psych ward by creating a hostile situation so I walked out. When I did he looked at her and said ” that’s how you do it.”
    and I sent in a complaint about it to the patient advocate and now I’m flagged for over a year. But thankfully I have Medicare now and have physical therapy for my 5 discs and they don’t yell at me and they’ve changed my medication slightly. I’ll never go back to the VHA hospitals or outpatient clinics again. But I don’t mind correcting their lies in the records they sent in and if I can I’d love to sue the system or the doctors because they are stealing from the American people and lying under their oath. The Dr. I’m speaking about even told me “doing nothing is something.” that’s how they think but you know they love to say Veterans malinger when they are the ones that do it. However getting flagged is probably real proof that I have ptsd even though all I did was walk out of the appointment to restrain myself from becoming physical.

  11. A document which should be read is VHA Directive 2010-053 Corrected copy which spells out a guideline on how they rate a veteran for flagging. Having had a head injury with loss of consciousness, a drinking problem, recent arrest or just telling you were in a fight are all factors leading to flagging and if you are a male you get bonus points.

    What needs to be done is full disclosure to the Veteran if he/she is flagged for any reason. A secret government designation is not in keeping with providing proper care to veterans.

    This is the web site which has this info:

  12. I can scarcely believe they do this but it certainly explains the treatment I have been getting. I was the victim of medical malpractice by an incompetent dr. shenyi peng at the Northport VA and he almost killed me and left me totally disabled and they are claiming he did nothing wrong eventhough 4 other hospitals claim otherwise.


  14. Over 30 years ago someone mentioned something to me about these PRF’s that the VA uses. How long has the VA been using these? How can I tell if I’ve been given a PRF? Is there some way I can look at progress notes or any other VA info. and tell if I’ve been given one? Over the years I have confronted a couple of people at the VA about bogus information they wrote about me on progress notes that they wrote. I’m wondering now if they have flagged my records for being disruptive or anything. How can I find out?

    1. Dennis, I am wanting to know the same info so I can check on me. I had a huge disagreement recently with the VA health care and as a result, they have been putting off trying to help me. I have an internal blood loss and they say I am fine. All of my numbers are so low that I can barely breath. I am receiving 6% of the oxygen with every breath so as result, I am pale can’t do anything, it is hard to walk 50 feet. But they tell me not to worry. I believe that this is a form of punishment from me getting very mad at them and letting them know what I thought. My new PCP that I have not even met had me sent to the Chronic Pain Safety Board and as a result the are stopping all of my chronic pain meds and told me I would have to “make a choice” and now I have to try to deal with pain that is unreal and they are not going to help me in that area either. So much BS from the VA. I am currently trying to get a different healthcare outside of the VA and hopefully I will never have to go back to them. They are a bunch of crooks and feel as if they have all the power over you and like they think they are God and can control you. We deserve so much more and better and they do not care.
      Ben how do we find out what Dennis and many of us vets are wanting to find out?

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